Clinical profile of cerebral venous thrombosis in pregnancy and puerperium in South India
Keywords:Antenatal period, CVT, Puerperium, Pregnancy
Background: Cerebral venous thrombosis (CVT) is any thrombosis occurring in intracranial veins and sinuses, which is a rare disorder affecting 5 persons per million per year with huge regional variation. Pregnancy and puerperium are the most prevalent prothrombotic states leading to cerebral venous thrombosis. The objective of this study was to analysis the clinical profile of CVT in pregnancy and puerperium.
Methods: In this prospective study, we analysed 52 consecutive patients admitted with impairment of consciousness, seizures or focal neurological deficit at our hospital. The diagnosis of CVT was confirmed by neuroimaging. Detailed history, clinical examination and laboratory investigations were carried out in all the cases and analysed.
Results: The incidence of CVT associated with pregnancy and puerperium at our Hospital was 3.9 per 1000 obstetric admissions. The age of the patients varied from 18-35 years with a maximum age incidence (77%) in the III decade (21-30 years). The maximum incidence was during the first two weeks of puerperium (61.8%). The most common presenting symptoms were focal or generalised seizures (88.4%) followed by headache (65.3%). In spite of the alarming clinical picture, recovery was rapid and remarkable. Total mortality was 15.5% (8 cases).
Conclusions: CVT is more common during the puerperium than in the antenatal period. Obstetric CVT has a more acute onset with excellent recovery when promptly diagnosed and treated.
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